Why not to stick Q-Tips in your ear

This week's episode of "Girls" featured an excruciating scene in which Hannah, grappling with OCD, inserted a Q-Tip deep into her ear canal and "heard air hiss out the hole" she'd apparently poked in her ear drum. Later, show creator Lena Dunham, who plays Hannah, tweeted: "If all I've done on this earth is scare you out of using Q-Tips, I will die a happy and purposeful woman." Is Dunham right? Should you really not be using Q-Tips?

There is a proper way to use Q-Tips and there is an improper way. If you're putting them in your ears, you're using them the improper way. Even Unilever, the company that makes the cotton swabs, warns that, when using them to clean the ears, you should "stroke . . . gently around the outer ear, without entering the ear canal." The word "ear" appears only eight times on the Q-Tips website, which emphasizes the cotton swab's non-aural uses: From polishing your silverware to "cleaning the small crevices of your dog or cat's face," it seems you should do anything with a Q-Tip but put it in your ear.

When it comes to removing earwax, every doctor I spoke to warned against putting anything in your ears. Stephen Rothstein, an ear, nose and throat doctor at NYU Medical Center, echoed the advice of Hannah's mother: He said his grandmother wisely told him to "never put anything smaller than an elbow in your ear." His grandmother also used to tell him, "Buy Q-Tips if you want to make an ear doctor rich."

The problem with removing earwax (by Q-Tip or any other home remedy) is that earwax serves important functions: It is a lubricant, a defense against foreign objects, and even a natural antibiotic. Earwax becomes a problem when it is packed into the canal and hardens, causing "impaction" (or blockage), and evidence shows that Q-Tips can cause impaction. A person suffering from impacted earwax may experience pain, dizziness, a ringing in the ears, or hearing loss. If you have wax impacted into your ear canal, you should see a doctor, who will remove it under a microscope -- perhaps using suction or bursts of water.

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Rothstein stressed the uselessness (and potential harm) of over-the-counter and as-seen-on-TV earwax removers. He'd recently seen a patient, for instance, who felt there was something wrong with his ear after he'd used an earwax vacuum to clean it. The man's ear was, in fact, blocked, but not by earwax: Inside the ear canal, Rothstein found a piece of the ear vacuum. Rothstein also warned specifically against the practice of ear candling, which involves holding a hollowed candle over your ear and letting it "vacuum out" the wax. "First," he said, "it doesn't work. And second, there's the issue of putting fire by your hair."